Abstract
Aim: Study aimed to test whether implants inserted in posterior mandible sites augmented with screw-guided bone regeneration (S-GBR) technique differ from implants placed in non-grafted sites regarding the success and survival rate. Materials and Methods: 20 edentulous patients (mean age 59.45 ± 15.220) were divided in a test group (S-GBR) (immediate implants placed simultaneously with grafting procedures) and control group (implants placed in naturally healed sites). Primary outcomes (implants success; implants survival) and secondary outcomes (clinical parameters of soft tissues: mPI; mGI; probing depth; keratinized mucosa; marginal-bone-level) were evaluated at 24-months follow-up. Results: Plaque levels were higher (p = 0.046) in S-GBR group (0.97 ± 0.882 mm) when compared with control (0.66 ± 0.695 mm). Keratinized mucosa width was higher in S-GBR group (4.13 ± 1.033 mm) than control (3.34 ± 0.821 mm) (p = 0.000) Probing depth (PD) width was higher in S-GBR group (3.50 ± 1.372 mm) than control (2.56 ± 1.332 mm) (p = 0.000). mGI was higher among implants placed in S-GBR group (0.90 ± 1.020 mm) than control (0.56 ± 0.794 mm) (p = 0.061). The difference between the average bone loss (MBL) for implants placed in grafted sites (Group S-GBR: 2.20 ± 1.867 mm) and for those placed in naturally healed sites (Group B: 1.09 ± 1.678 mm) was statistically significant (p = 0.000). The overall implant success rate after 24-month follow-up was 76.7% in S-GBR group and 90.6% in control group (p = 0.001). The survival rate after 24-month follow-up was 86.7% in S-GBR group and 93.8% in control group (p = 0.182). The reconstruction of the alveolar bone using S-GBR technique and immediate implant placement is a valid guided bone regeneration strategy for mandibular alveolar bone with severe horizontal resorption. The choice of S-GBR technique should be based on specific indications as implants placed in grafted sites recorded worse marginal success rate, survival rate and bone resorption than those placed in non-grafted sites.
Highlights
The implant-prosthetic treatment of partially edentulous patients has become in last 20 years a routine treatment procedure with reliable functional and esthetic results
screw-guided bone regeneration (S-GBR) technique should be based on specific indications as implants placed in grafted sites recorded worse marginal success rate, survival rate and bone resorption than those placed in non-grafted sites
Study aimed to test whether implants inserted in posterior mandible sites augmented with screw-guided bone regeneration (S-GBR) technique differ from implants placed in non-grafted sites regarding success rate, survival rate, interproximal marginal bone level (MBL), and clinical parameters of peri-implant soft tissues
Summary
The implant-prosthetic treatment of partially edentulous patients has become in last 20 years a routine treatment procedure with reliable functional and esthetic results. A functional and stable mandibular implant-prosthetic restoration in posterior area can be compromised in the long term due to shape and orientation of the residual alveolar bone, improper sagittal intermaxillary relationships as well as the presence of mandibular inferior nerves. These clinical situations require the enhancement of the alveolar bone volume and quality for long-term success of the implant-prosthetic therapy. A various range of bone regenerative bone have been proposed to create conditions for long term success of the implant-prosthetic restorations in mandible posterior areas (guided bone regeneration (GBR), distraction osteogenesis, alveolar ridge splitting techniques, bone expansion techniques, bone grafting techniques) [2,3]. A scientifically validated opinion on which is the best technique and grafting materials is hard to obtain, especially in posterior mandible area
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